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Generic Name: Alendronate 40 mg Tablets (a-LEN-droe-nate) Brand Name: FosamaxFosamax is used for:Treating Paget disease. It may also be used for other conditions as determined by your doctor. Fosamax is a bisphosphonate. It works by slowing bone loss.Do NOT use Fosamax if:• you are allergic to any ingredient in Fosamax• you have certain esophagus problems (eg, narrowing, blockage)• you are unable to stand or sit upright for at least 30 minutes• you have low blood calcium levels or severe kidney problemsContact your doctor or health care provider right away if any of these apply to you.Before using Fosamax:Some medical conditions may interact with Fosamax . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:• if you are pregnant, planning to become pregnant, or are breast-feeding• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement• if you have allergies to medicines, foods, or other substances• if you have a history of stomach or bowel problems (eg, inflammation, ulcer), esophagus problems (eg, heartburn, reflux disease, severe irritation), or kidney problems, or if you have difficult or painful swallowing• if you have low blood vitamin D levels, mental problems, cancer, anemia, blood clotting problems, an infection, or calcium metabolism problems• if you have poor dental hygiene, other dental problems, or you will be having a dental procedure• if you smoke or drink alcohol• if you take a corticosteroid (eg, prednisone), or you have had or will be having chemotherapy or radiation treatmentSome MEDICINES MAY INTERACT with Fosamax . Tell your health care provider if you are taking any other medicines, especially any of the following:• Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of side effects, such as esophagus or stomach irritation, may be increasedThis may not be a complete list of all interactions that may occur. Ask your health care provider if Fosamax may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.How to use Fosamax:Use Fosamax as directed by your doctor. Check the label on the medicine for exact dosing instructions.• An extra patient leaflet is available with Fosamax . Talk to your pharmacist if you have questions about this information.• Swallow Fosamax whole. Do not break, crush, chew, or suck on the tablet before swallowing.• Take Fosamax by mouth on an empty stomach in the morning at least 30 minutes before your first food, drink, or other medicine of the day. Do NOT take Fosamax at bedtime or before you get out of bed in the morning.• Take Fosamax with a full glass of plain water (8 oz/240 mL). Do not take Fosamax with mineral water, coffee, tea, or juice. Do not lie down for 30 minutes after taking Fosamax and until you eat your first food of the day.• Be sure you understand how to take Fosamax . Contact your doctor or pharmacist if you have any questions.• Continue to use Fosamax even if you feel well. Do not miss any doses.• If you miss a dose of Fosamax , do not take it later in the day. Take it the morning after you remember and then go back to your regular dosing schedule. Do not take 2 doses at once.Ask your health care provider any questions you may have about how to use Fosamax.Important safety information:• Fosamax may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Fosamax with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.• Talk with your doctor before you drink alcohol, smoke, or use other tobacco products while taking Fosamax .• Follow the diet and exercise program given to you by your health care provider. Talk to your doctor about whether you should take a calcium and vitamin D supplement while you use Fosamax .• Talk to your doctor about the use of weight-bearing exercises to help prevent weak bones.• Fosamax may cause jaw bone problems in some patients. Your risk may be greater if you have cancer, poor dental hygiene, or certain other conditions (eg, anemia, blood clotting problems, infection, dental problems). You risk may also be greater if you use certain medicines or therapies (eg, chemotherapy, corticosteroids, radiation). Talk to your doctor about having a dental exam before you start to use Fosamax . Ask your doctor any questions you may have about dental treatment while you use Fosamax .• Proper dental care is important while you are taking Fosamax . Brush and floss your teeth and visit the dentist regularly.• Fosamax may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Fosamax. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.• Tell your doctor or dentist that you take Fosamax before you receive any medical or dental care, emergency care, or surgery.• Lab tests, including bone density and blood calcium levels, may be performed while you use Fosamax . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.• Fosamax should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Fosamax while you are pregnant. It is not known if Fosamax is found in breast milk. If you are or will be breast-feeding while you use Fosamax , check with your doctor. Discuss any possible risks to your baby.Possible side effects of Fosamax:All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:• Bone, muscle, or joint pain; constipation; diarrhea; dizziness; feeling bloated or full; flu-like symptoms at the start of treatment; gas; headache; mild stomach pain; nausea; taste changes; vomiting.Seek medical attention right away if any of these SEVERE side effects occur:• Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry, or bloody stools; chest pain; coughing or vomiting blood; difficult or painful swallowing; mouth sores; new, worsening, or severe heartburn; red, swollen, blistered, or peeling skin; severe bone, muscle, or joint pain; severe or persistent sore throat or stomach pain; swelling of the hands, legs, or joints; swelling or pain in your jaw.This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider.Proper storage of Fosamax :Store Fosamax at room temperature, between 59 and 86 degrees F (15 and 30 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Fosamax out of the reach of children and away from pets.